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For unknown reasons, about one in six people who recovered from COVID-19 retested positive after at least two weeks, the researchers reported in a study in Italy.
Sore throat and rhinitis were the only symptoms associated with positive results. “Patients with persistent respiratory symptoms were more likely to get new positive tests,” said lead author Francesco Randy, MD. Medscape Medical News.
“This suggests that the persistence of respiratory symptoms should not be underestimated and should be adequately evaluated in all patients who are considered to have recovered from COVID-19,” he said. Stated.
“The findings are interesting,” said Dr. Akiko Iwasaki, an immunobiologist at Yale University and Howard Hughes Medical Institute. Medscape Medical News. “Although there are other reports of RNA detection after discharge, the study found that of the many symptoms, only two were PCR-positive, sore throat and rhinitis. “
The· Survey Published online on September 18th American Journal of Preventive Medicine.
Findings can have important implications for people with persistent symptoms. “Be cautious, avoid close contact with others, wear a face mask, and in some cases receive an additional nasopharyngeal swab,” said Randy, an associate professor of internal medicine at the Catholic Sacred Heart University in Rome, Italy. Is. “
“One of the most interesting findings is that persistent symptoms do not correlate with PCR positivity, suggesting that symptoms are often not due to ongoing viral replication,” said Case’s molecule. Dr. Jonathan Khan, Professor and Chairman of the Faculty of Biology and Microbiology, Western Reserve University School of Medicine, Cleveland, Ohio Medscape Medical News When asked to comment.
“The key technical issue they discussed is that the viral RNA signal in the PCR assay does not necessarily mean that an infectious virus is present,” Khan said. He added that a new comprehensive viral RNA analysis is needed to answer this question.
Official COVID-19 recovery
To identify risk factors and COVID-19 survivors who are likely to be positive for retesting, Landi and members of the Gemelli Against COVID-19 Acute Treatment Study Group evaluated 131 patients after discharge.
All participants met World Health Organization Standards for Freedom from Isolation, Containing two negative test results at least 24 hours apart, was investigated from April 21st to May 21st. The average age was 56 years and 39% were women. Only a slightly higher mean BMI of 25.9 kg / m2 in the negative group was significant compared to 27.6 kg / m2 in the positive group.
Fatigue, 44%, and coughing in 17% of the survivors were not significantly different between the groups. In contrast, 18% of positive survivors and 4% of negative survivors had a sore throat (P = .04), and 27% vs. 12%, respectively, reported rhinitis (P = .05).
People returned for a follow-up visit after an average of 17 days after the second negative swab test.
Asymptomatic COVID-19 carrier?
“These findings indicate that a remarkable proportion of patients who have recovered with COVID-19 may still be asymptomatic carriers of the virus,” the researchers said in a paper. “Twenty-two patients who were again positive for COVID-19, even in the absence of specific guidelines, were offered a second quarantine.”
Close contact with family members and positive survivors has not reported SARS-CoV-2 infection. All patients continued to wear masks and adhered to social distance recommendations. This makes it “very difficult to tell if these patients were really contagious,” the researchers say.
Next Step
Evaluating all COVID-19 survivors and identifying those who retested positive is important for a better understanding of both the natural history of COVID-19 and the public health effects of viral shedding. It will be a great contribution, “the author writes.
One of the limitations of the study is that the RT-PCR test reveals a gene sequence unique to COVID-19. “It’s important to emphasize that this is not a virus culture and it is not possible to determine if the virus is viable and contagious,” the researchers say.
“In this regard, we are trying to better understand whether the persistence of long-term positive RT-PCR testing for COVID-19 really correlates with potential infectivity,” they add.
Landi et al. Stated that the findings should be considered preliminary and that larger data samples are needed to validate the results.
Landi and Karn do not disclose the relevant financial relationship. Iwasaki disclosed a research grant from Condea, a 5% stake in RIGImmune, and more than $ 250 in revenue from PureTec.
J prevents Med. Published online on September 18, 2020. Full text
Damian McNamara is a Miami-based staff journalist. He covers a wide range of medical disciplines, including infectious diseases, gastroenterology and rheumatology. Follow Damian on Twitter: @MedReporter..
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